Customer Service Associate

Job Description Position Title: Customer Service Associate Location: Viskahpatnam Employment Type: Full-Time Job Summary The Customer Service Associate will play a critical role in managing customer interactions, particularly related to cashless and reimbursement claims processes, health checkup coordination, and insurance policy endorsements. The ideal candidate will demonstrate exceptional communication skills, empathetic customer handling, and the ability to navigate complex processes to ensure a seamless experience for our customers. Key Responsibilities Cashless Claims Process: - Promptly respond to customer calls regarding hospital admissions. - Advise customers on the benefits of opting for cashless hospitalization. - Provide a list of network hospitals where cashless services are available. - Guide customers through the pre-approval process with the insurance desk. - Assist in obtaining discharge approval after treatment completion. - Follow up with the insurance company using the claim number provided by the hospital. Reimbursement Claims Process - Handle customer calls related to visits to non-network hospitals. - Advise on the process of notifying insurers about the claim. - Guide customers in collecting required medical bills and forms. - Share a checklist to help customers organize documents for claim submission. - Assist customers in submitting documents online or via courier. - Monitor and update customers on the status of submitted claims. - Resolve queries and ensure timely payment disbursement after claim approval. Health Checkups Coordination - Schedule health checkup appointments as per customer requests. - Verify customer authentication through OTP for website login. - Organize comprehensive health checkups, including date, time, and location details. - Provide options for home service or center-based health checkups. - Share confirmation details and ensure timely delivery of health checkup reports. Endorsements Management - Collect necessary data from corporate HR for insurance endorsements. - Accurately enter and update collected data in relevant systems. - Navigate ICICI and third-party portals for data submission. - Upload data files and premium breakdown reports to respective portals. - Coordinate with HR for endorsement approvals and payment processing. - Distribute E-cards post-endorsement approval. Customer Feedback Management - Schedule and conduct Google reviews and testimonial calls with customers. - Document and compile customer feedback for service quality improvement. - Analyze feedback trends and share insights for continuous improvement. Ticket Management In Zoho - Raise tickets in the Zoho system for all customer interactions. - Ensure timely resolution by coordinating with internal departments. - Maintain detailed records of ticket statuses and resolutions. Immediate Availability & Emergency Response - Ensure prompt availability to answer customer calls, especially during emergencies. - Provide empathetic and efficient assistance for emergency claims. - Coordinate emergency response with insurance providers for quick claim processing. Corporate Policy Renewals - Coordinate with corporate clients for policy renewals. - Request and compile data for renewal quotations. - Liaise with insurance providers to obtain competitive renewal quotes. - Present renewal options and ensure timely policy renewals. Customer Satisfaction Enhancement - Engage with customers to understand their needs and provide personalized assistance. - Implement strategies to enhance customer satisfaction and loyalty. Customer Education And Support - Conduct training sessions or provide information on insurance processes and benefits. Continuous Improvement - Identify and implement opportunities for service delivery and operational efficiency improvements. Team Collaboration - Work with other departments to resolve customer issues and improve service quality. Compliance And Quality Assurance - Ensure compliance with regulatory requirements and internal quality standards. Reporting And Documentation - Maintain accurate records, prepare reports, and document customer interactions. Problem Resolution Management - Handle escalated customer issues and ensure prompt resolution. - Collaborate with relevant departments for complex queries. Quality Assurance - Conduct quality checks on customer interactions to ensure service standards are met. - Provide feedback and coaching to team members to improve service quality. Qualifications - Bachelor's degree or equivalent experience in customer service or a related field. - Minimum 2 years of experience in a customer service role, preferably in insurance or healthcare. - Strong communication and interpersonal skills. - Proficiency in using ticketing systems like Zoho and navigating insurance portals. - Ability to handle high-pressure situations, especially during emergencies. - Attention to detail and strong organizational skills. Compensation - Competitive salary commensurate with experience. - Benefits package including health insurance, paid time off, and professional development opportunities.